Background
Background to multiple behaviour change
Methods
Participants and setting
Interviews
Intervention | Control | |
---|---|---|
Gender | ||
Male | 7 | 7 |
Female | 12 | 14 |
Age | ||
30–40 | 3 | 2 |
41–50 | 9 | 10 |
51–60 | 2 | 4 |
61–70 | 4 | 6 |
>70 | 2 | 1 |
BMI | ||
Normal weight | 6 | 6 |
Overweight | 5 | 5 |
Obese | 5 | 7 |
Morbidly obese | 3 | 3 |
Cigarette consumption | ||
<20 | 7 | 8 |
20–30 | 10 | 10 |
>30 | 2 | 3 |
Analysis
A Priori themes | Emergent themes |
---|---|
· Psychological mechanisms for change related to the TTM and to the proven efficacy of group interactions | · Vicious and virtuous circles of change |
· Physiological mechanisms relating to negative impacts of eating as a replacement to smoking and to positive impacts of improved respiratory function on physical activity | · Psychological mechanisms relating to awareness of eating as a replacement to smoking |
· Health behaviours as integrated or discrete; sequential or simultaneous |
Results
Diet, physical activity and smoking as separate behaviours to be tackled sequentially
Theme | Illustrative quotations |
---|---|
Important to take one task at a time
| 49(I): I feel that if I really push myself … I’m frightened I might just resort to having a cigarette instead … I’d rather that [smoking cessation] is done and dusted. [Q, <3%, 24th week] |
56(C): I don’t see the point in doing all this exercise when I’m still smoking anyway, so I’d rather nip that [smoking cessation] in the bud. [NQ, >3%, 24th week] | |
44(C): Smoking was the last thing to deal with, I’ve dealt with the drinking, dealt with the weight, dealt with the smoking. [Q, <3%, 24th week] |
Theme: | Illustrative quotations |
---|---|
Inevitability of eating filling space left by smoking | 57(C): It’s your metabolism, so you are eating more, you are compensating for a cigarette and you’re not compensating with an apple or a banana or an orange. [Q, <3%, 24th week] |
46(I): Maybe you think ‘I’ll have a cup of tea and biscuit’ but I don’t want to do that so now it’s back to a wee cup of tea and cigarette. I need to be doing something, one or other. [NQ, <3%, 24th week] |
Concurrent behaviour change
Theme: | Illustrative quotations |
---|---|
No desire to replace one set of illnesses with another | 12(I): It’s one thing cutting out the cigarettes to cut out heart disease, but you’re just going to kill yourself anyway if you’re eating all these fatty foods. [NQ, <3%, 6th week] |
65(I): There’s no point in improving one side of your health to let the other side deteriorate. [Q, >3%, 24th week] | |
21(C): I don’t want to [think] I’ve done one healthy thing and then all of a sudden I’m obese. [Q, <3%, 6th week] | |
Difficult to separate out individual behaviour changes | 2(I): I’m willing to do anything to better my life from stopping smoking and eating healthily … and getting some form of exercise – Now, the three of them go hand in hand, don’t they. [Q, <3%, 6th week] |
35(C): Everything works in as one thing, you know, your not smoking, your eating healthy food, your on a control diet or whatever it is and your exercising – it’s not just four different things. [Q, <3%, 6th week] | |
Focus on multiple behaviours reduces focus on one alone | 18(I): My daughter says ‘you don’t think it’s a bit much to focus on the two at the same time’ but I find it’s actually quite good because it takes my mind [off]. If I’m thinking about one, I’m not thinking about the other. [Q, <3%, 6th week] |
23(C): I think it would take your mind off thinking about cigarettes – you’ve got something else to think about and to focus on, so you’re not going [to] be focusing on cigarettes all the time. [Q, <3%, 6th week] |
Theme: | Illustrative quotations |
---|---|
Physiological mechanisms | 9(I): Fantastic. I just like the taste … when I was smoking and you were eating a piece of fruit it just tasted the same kind of bland … this time it’s really lovely … your carrot and your broccoli and all the different things that I’m eating … it’s just a lovely taste. [Q, >3%, 6th week] |
20(C): Now you can taste what it’s supposed to taste like. [Q, >3%, 6th week] | |
47(I): My exercises – I can do a lot more because I’m not breathless, I can go up and down the stairs no bother. I just feel a lot healthier, a lot fitter and healthier. [Q, >3%, 24th week] | |
Psychological mechanisms | 61(C): You know hard physical exercise makes you feel good and … healthy eating makes you feel good … and the smoking got to be a no no. [NQ, <3%, 24th week] |
9(I): I feel more refreshed and raring to go and I look forward to the day. [Q, >3%, 6th week] |
Vicious and virtuous circles
Theme: | Illustrative quotations |
---|---|
Vicious circles | 67(C): When I never had a cigarette I had this in my head … your lungs start clearing … inside me is getting cleared out so I’ll watch what I’m putting in … I was drinking plenty of water, fruit, vegetables, exercise every day and when I went back on the cigarettes, to hang with it, I started eating, fruit and veg is out the window and I’m back to the old sort of style [and] I’m actually smoking more. [NQ, >3%, 24th week] |
3(I): I’m angry at myself [for over-eating] – I shouldn’t be giving in to it – I’m actually worrying about it and, you know, it’s making me want to smoke … it’s a vicious circle really. [Q, >3%, 6th week] | |
Virtuous circles | 65(I): If you’re eating the right stuff and you see yourself not putting on weight and feel fitter it gives you that extra gee to get up in the morning, your chest’s clear, you’ve not got a smoker’s cough, overall you feel better. [Q, >3%, 24th week] |
34(I): It [smoking cessation] is making me want to go to the gym and get my fitness back – if you’re feeling fit and you’ve got it in your mind that you’ve given up the smoking and you’re putting all the good nutrients into your body, well, aye, that would drive me on. [DO, 6th week] |